Provider Demographics
NPI:1073302576
Name:FARMER, BENJAMIN FRANKLIN (CDCA)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:FRANKLIN
Last Name:FARMER
Suffix:
Gender:
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4373 RHODES AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5532
Mailing Address - Country:US
Mailing Address - Phone:740-981-6382
Mailing Address - Fax:740-529-7085
Practice Address - Street 1:4502 GALLIA ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-5541
Practice Address - Country:US
Practice Address - Phone:740-529-7020
Practice Address - Fax:740-529-7085
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH192051101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)